The Relationship Between Baseline Blood Pressure and Computed Tomography Findings in Acute Stroke Data From the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST)

G.M. Sare; P.M.W. Bath; L.J. Gray; T. Moulin; F. Woimant; T. England; C. Geeganage; Hanne Krarup Christensen; P.P. De Deyn; D. Leys; D. O'Neill; E.B. Ringelstein

The Relationship Between Baseline Blood Pressure and Computed Tomography Findings in Acute Stroke Data From the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST)

G.M. Sare, P.M.W. Bath, L.J. Gray, T. Moulin, F. Woimant, T. England, C. Geeganage, Hanne Krarup Christensen, P.P. De Deyn, D. Leys, D. O'Neill, E.B. Ringelstein

8 Citations (Scopus)

Abstract

Background and Purpose-High blood pressure (BP) is present in approximate to 80% of patients with acute ischemic stroke and is independently associated with poor outcome. There are few data examining the relationship between admission BP and acute CT findings. Methods-TAIST was a randomized controlled trial assessing 10 days of treatment with tinzaparin versus aspirin in 1489 patients with acute ischemic stroke (<48 hr) with admission BP of <= 220/120 mm Hg. CT brain scans were performed before randomization and after 10 days. The relationships between baseline BP and adjudicated CT findings were assessed. Odds ratios per 10 mm Hg change in BP were calculated. Results-Higher systolic BP (SBP) was associated with abnormal CT scans because of independent associations with chronic changes of leukoariosis (OR, 1.12; 95% CI, 1.05-1.17) and old infarction (OR, 1.12; 95% CI, 1.06-1.17) at baseline, and signs of visible infarction at day 10 (OR, 1.06; 95% CI, 1.00-1.13). A lower SBP was associated with signs of acute infarction (OR, 0.94; 95% CI, 0.89-0.99). Hemorrhagic transformation, dense middle cerebral artery sign, mass effect, and cerebral edema at day 10 were not independently associated with baseline BP. Conclusion-Although high baseline BP is independently associated with a poor outcome after stroke, this was not shown to be through an association with increased hemorrhagic transformation, cerebral edema, or mass effect; trial design may be suboptimal to detect this. Higher SBP is associated with visible infarction on day 10 scans. The influence of changing BP in acute stroke on CT findings is still to be ascertained. (Stroke. 2009;40:41-46.)
Udgivelsesdato: 2009/1

Original language	English
Journal	Stroke
Volume	40
Issue number	1
Pages (from-to)	41-46
Number of pages	5
ISSN	0039-2499
Publication status	Published - 2009

Cite this

@article{634c04c08b3811df928f000ea68e967b,

title = "The Relationship Between Baseline Blood Pressure and Computed Tomography Findings in Acute Stroke Data From the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST)",

abstract = "Background and Purpose-High blood pressure (BP) is present in approximate to 80% of patients with acute ischemic stroke and is independently associated with poor outcome. There are few data examining the relationship between admission BP and acute CT findings. Methods-TAIST was a randomized controlled trial assessing 10 days of treatment with tinzaparin versus aspirin in 1489 patients with acute ischemic stroke (<48 hr) with admission BP of <= 220/120 mm Hg. CT brain scans were performed before randomization and after 10 days. The relationships between baseline BP and adjudicated CT findings were assessed. Odds ratios per 10 mm Hg change in BP were calculated. Results-Higher systolic BP (SBP) was associated with abnormal CT scans because of independent associations with chronic changes of leukoariosis (OR, 1.12; 95% CI, 1.05-1.17) and old infarction (OR, 1.12; 95% CI, 1.06-1.17) at baseline, and signs of visible infarction at day 10 (OR, 1.06; 95% CI, 1.00-1.13). A lower SBP was associated with signs of acute infarction (OR, 0.94; 95% CI, 0.89-0.99). Hemorrhagic transformation, dense middle cerebral artery sign, mass effect, and cerebral edema at day 10 were not independently associated with baseline BP. Conclusion-Although high baseline BP is independently associated with a poor outcome after stroke, this was not shown to be through an association with increased hemorrhagic transformation, cerebral edema, or mass effect; trial design may be suboptimal to detect this. Higher SBP is associated with visible infarction on day 10 scans. The influence of changing BP in acute stroke on CT findings is still to be ascertained. (Stroke. 2009;40:41-46.) Udgivelsesdato: 2009/1",

author = "G.M. Sare and P.M.W. Bath and L.J. Gray and T. Moulin and F. Woimant and T. England and C. Geeganage and Christensen, {Hanne Krarup} and Deyn, {P.P. De} and D. Leys and D. O'Neill and E.B. Ringelstein",

note = "Times Cited: 2ArticleEnglishBath, P. M. WUniv Nottingham, Stroke Trials Unit, Inst Neurosci, Clin Sci Bldg,City Hosp Campus, Nottingham NG7 2UH, EnglandCited References Count: 24388ZNLIPPINCOTT WILLIAMS & WILKINS530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USAPHILADELPHIA",

year = "2009",

language = "English",

volume = "40",

pages = "41--46",

journal = "Stroke",

issn = "0039-2499",

publisher = "Lippincott Williams & Wilkins",

number = "1",

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TY - JOUR

T1 - The Relationship Between Baseline Blood Pressure and Computed Tomography Findings in Acute Stroke Data From the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST)

AU - Sare, G.M.

AU - Bath, P.M.W.

AU - Gray, L.J.

AU - Moulin, T.

AU - Woimant, F.

AU - England, T.

AU - Geeganage, C.

AU - Christensen, Hanne Krarup

AU - Deyn, P.P. De

AU - Leys, D.

AU - O'Neill, D.

AU - Ringelstein, E.B.

N1 - Times Cited: 2ArticleEnglishBath, P. M. WUniv Nottingham, Stroke Trials Unit, Inst Neurosci, Clin Sci Bldg,City Hosp Campus, Nottingham NG7 2UH, EnglandCited References Count: 24388ZNLIPPINCOTT WILLIAMS & WILKINS530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USAPHILADELPHIA

PY - 2009

Y1 - 2009

N2 - Background and Purpose-High blood pressure (BP) is present in approximate to 80% of patients with acute ischemic stroke and is independently associated with poor outcome. There are few data examining the relationship between admission BP and acute CT findings. Methods-TAIST was a randomized controlled trial assessing 10 days of treatment with tinzaparin versus aspirin in 1489 patients with acute ischemic stroke (<48 hr) with admission BP of <= 220/120 mm Hg. CT brain scans were performed before randomization and after 10 days. The relationships between baseline BP and adjudicated CT findings were assessed. Odds ratios per 10 mm Hg change in BP were calculated. Results-Higher systolic BP (SBP) was associated with abnormal CT scans because of independent associations with chronic changes of leukoariosis (OR, 1.12; 95% CI, 1.05-1.17) and old infarction (OR, 1.12; 95% CI, 1.06-1.17) at baseline, and signs of visible infarction at day 10 (OR, 1.06; 95% CI, 1.00-1.13). A lower SBP was associated with signs of acute infarction (OR, 0.94; 95% CI, 0.89-0.99). Hemorrhagic transformation, dense middle cerebral artery sign, mass effect, and cerebral edema at day 10 were not independently associated with baseline BP. Conclusion-Although high baseline BP is independently associated with a poor outcome after stroke, this was not shown to be through an association with increased hemorrhagic transformation, cerebral edema, or mass effect; trial design may be suboptimal to detect this. Higher SBP is associated with visible infarction on day 10 scans. The influence of changing BP in acute stroke on CT findings is still to be ascertained. (Stroke. 2009;40:41-46.) Udgivelsesdato: 2009/1

AB - Background and Purpose-High blood pressure (BP) is present in approximate to 80% of patients with acute ischemic stroke and is independently associated with poor outcome. There are few data examining the relationship between admission BP and acute CT findings. Methods-TAIST was a randomized controlled trial assessing 10 days of treatment with tinzaparin versus aspirin in 1489 patients with acute ischemic stroke (<48 hr) with admission BP of <= 220/120 mm Hg. CT brain scans were performed before randomization and after 10 days. The relationships between baseline BP and adjudicated CT findings were assessed. Odds ratios per 10 mm Hg change in BP were calculated. Results-Higher systolic BP (SBP) was associated with abnormal CT scans because of independent associations with chronic changes of leukoariosis (OR, 1.12; 95% CI, 1.05-1.17) and old infarction (OR, 1.12; 95% CI, 1.06-1.17) at baseline, and signs of visible infarction at day 10 (OR, 1.06; 95% CI, 1.00-1.13). A lower SBP was associated with signs of acute infarction (OR, 0.94; 95% CI, 0.89-0.99). Hemorrhagic transformation, dense middle cerebral artery sign, mass effect, and cerebral edema at day 10 were not independently associated with baseline BP. Conclusion-Although high baseline BP is independently associated with a poor outcome after stroke, this was not shown to be through an association with increased hemorrhagic transformation, cerebral edema, or mass effect; trial design may be suboptimal to detect this. Higher SBP is associated with visible infarction on day 10 scans. The influence of changing BP in acute stroke on CT findings is still to be ascertained. (Stroke. 2009;40:41-46.) Udgivelsesdato: 2009/1

M3 - Journal article

SN - 0039-2499

VL - 40

SP - 41

EP - 46

JO - Stroke

JF - Stroke

IS - 1

ER -